Wiki V58.69 w/ 314.01

[kattekatt]

My billing manager (not a coder) just walked by and told me that we are billing the med check appts for ADD/ADHD wrong- she states that we have to bill w/ the V58.69 first and the then 314.xx next-- she states that since we are billing it the 314.xx ,V58.69 the claims are going to deductible and that is incorrect. My view is that the reason that I am coding correctly w/ the 314.xx,V58.69 and that the claims are going to deductible because they fall under the mental health area of the insurance policy which can have a deductible on it. Is there any where that I can print out that the V code cannot be used as a prmy code - or am I wrong?

Thanks

 

[dwebb58]

v58.69 w/ 314.01

according to Coding Clinic the V58.69 cannot be primary code only a secondary if using only v58.69 then you also have to use V58.83 as primary and then any other codes.

 

[tbrandt]

V58.69

The V code table shows V58.69 is coded as an additional dx only. I'd show your manager this table.

 

[kattekatt]

I talked to the billing mgr a little while ago to ask her what prompted this issue- she told me that a BCBS rep told her that if we billed the ov w/ the
V58.69, 314.xx then it would of paid in full and not went to the deductible. I guess not even the insurance wants us to code it correctly

I gave her the V58.83 code and she seemed ok to use that code as the prmy but still wants to use the 314.xx code as the secondary code.

 

[mitchellde]

If the visit is for a med check then the V58.83 is the appropriate dx first listed with the V58.69 second then the 314.xx third.